While Orange County is slowly making progress to address coronavirus vaccination disparities for the county’s hardest hit residents, a state partnership with Blue Shield to distribute the shots could hamper those efforts even further.

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The health care provider is expected to take over vaccine distribution for Southern California beginning March 7, but questions remain on how supplies will be distributed to community health clinics that are targeting vulnerable seniors in OC’s hardest hit neighborhoods

Isabel Becerra, CEO of the Coalition of Orange County Community Health Centers, is concerned the distribution changes could affect efforts to vaccinate the hardest hit communities. 

“Unless you have a contract with Blues Shield, you stand to be left out of that distribution process,” Becerra said in a Wednesday phone interview. “To date, that I know of, no community health center has been approached with a contract, nor have we begun communications.” 

The state Government Operations Agency has to approve vaccine provider contracts before becoming part of the distribution system, according to the contract with Blue Shield.

The contract also calls for Blue Shield to select vaccine providers. 

“Blue Shield will promptly notify the Agency regarding Blue Shield’s selection of Vaccine Providers to be offered Model Contracts for participation in the State Vaccine Network. For the initial phase of Vaccine Provider Credentialing, Blue Shield currently intends to focus participation efforts on a limited number of providers that Blue Shield, in consultation with the Agency, believes are able to meet or exceed capacity, equity, and geographic reach concerns,” reads the contract. 

Becerra said she hopes the federally funded OC community health clinics can circumvent that process by piggybacking on the county Health Care Agency’s expected contract with Blue Shield. 

“I’m asking them to include us as their partners because they will be getting a contract,” Becerra said. “I am asking for the health centers to also be included and not disrupt what I believe is a very efficient and targeted way to address the vulnerable community such as working through the community health centers.” 

The contract calls for a focus on the hardest hit communities.

A Blue Shield representative directed a reporter’s questions to state public health officials Wednesday about how the health care provider is going to work with community clinics in the hardest hit neighborhoods. 

State health officials haven’t responded to questions about how community clinics will be contracted. 

Blue Shield spokeswoman Erika Conner said members won’t be given priority during the distribution process. 

“The state will be responsible for determining eligibility and priority for vaccinations, and vaccine allocations will be based on criteria determined by the state,” Conner said in a Wednesday email.

In a Wednesday text message, Orange County health officer Dr. Clayton Chau said he’s not certain how the distribution to community clinics is going to work because county officials are still scheduling a meeting with Blue Shield representatives. 

Meanwhile, Becerra said OC’s network of community health clinics have already proven themselves capable of vaccinations. 

“I think we established that we’re able to carry out the work. To date we have received about 21,000 vaccines to the collective group and we provided about 20,000 vaccines. So we’re getting them out as fast as we’re getting them in,” Becerra said. “We provide the solution for the equity distribution in the hardest hit communities.”

Some minorities, especially the Latino community, have been lagging behind OC’s vaccination process.

As of last Thursday, the Latino community has received 12% of the over half a million doses administered.

Latinos, while making up roughly 35% of OC’s residents, have nearly 45% of cases and almost 38% of the virus deaths.

In comparison, white people received 48% of the vaccines, make up over 38% of the county’s residents, have roughly 25% of cases and 37% of deaths. 

The disparities are even more apparent in the senior category of vaccine distribution numbers, according to the county tracker. 

Roughly 278,000 vaccines have been distributed to more than 232,000 seniors in OC.

White people received 58% of vaccines for people 65 and older, while Latinos account for 10%.

It’s an issue that’s not just localized to Orange County, but across the state. 

Kiran Savage-Sangwan, executive director of the California Pan-Ethnic Health Network, said there’s vaccine distribution issues up and down the state. 

“There’s a huge inequity so far in who’s been vaccinated so far in the early stages of the vaccine rollout,” Savage-Sangwan said in a Wednesday phone interview. “Everyone needs to have a laser focus on ensuring that particularly communities of color start to get a much greater share of vaccines.” 

The Sacramento-based network is a health care advocacy group, which focuses on bringing health coverage to the state’s poorest residents.

Savage-Sangwan echoed concerns that some local community leaders and infectious disease experts have about getting the most vulnerable people vaccinated: lack of access to the big sites. 

“I think the biggest barrier is access. Where do we put our sites, who do we say is eligible, how do we get people there, what hours are the sites that are open?” she said. “The biggest thing we need to do is bring the vaccine into the community. Right now we’re expecting people to go to the vaccine and that’s not realistic for people who work long hours, have two jobs.” 

Becerra echoed similar concerns. 

“I definitely agree, I think that more concentration in the hardest hit areas is definitely warranted,” Becerra said, adding that the vaccination supersites like Disneyland and Soka University are helpful for the overall effort, but they are difficult for some of the most vulnerable residents to get to.

As of Wednesday, 515 people were hospitalized, including 151 in intensive care units.

That’s roughly a quarter of hospitalizations Orange County had in early January. 

In total, the virus has now killed 3,848 people — more than seven times the flu does on a yearly average. 

For context, Orange County has averaged around 20,000 deaths a year since 2016, including  543 annual flu deaths, according to state health data.

It’s also killed more than heart disease, Alzheimer’s disease and strokes do on a yearly average, respectively. 

According to the state death statistics, cancer kills over 4,600 people, heart disease kills over 2,800, more than 1,400 die from Alzheimer’s disease and strokes kill over 1,300 people.

Orange County has already surpassed its yearly average 20,000 deaths, with 23,883 people dead as of December, according to the latest available state data.

Becerra said she worries cases could uptick if people let their guards down — similar to what happened before the Summer and Winter waves. 

“I think the behaviors are changing and I’m seeing a downward trend and I’m always fearful that causes a false sense of security,” she said. “We’ve already seen it happen twice.”

For more details on the COVID-19 vaccine in Orange County view our Voice of OC information page: http://bit.ly/occovidvaccine.

Here’s the latest on the virus numbers across Orange County from county data:

Infections | Hospitalizations & Deaths | City-by-City Data | Demographics

Spencer Custodio is a Voice of OC staff reporter. You can reach him at scustodio@voiceofoc.org. Follow him on Twitter @SpencerCustodio

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